I always have an idea of what to write about every month, however a new alert just came in from the European Centre of Disease Prevention and I have to share this with you.

#CANADA

We were notified that in Alberta, Canada, gonorrhoea and infectious syphilis, have reached "outbreak levels". The Senior Medical Officer of Health said though numerous factors causing the outbreak had been identified, a significant number of recent STI cases involved the use of social media or websites to find casual and sometimes anonymous hook-ups."That's part of what's fuelling this outbreak," he said. "The concern we have is that people are engaging in high-risk behaviour without adequate protection." With any case of gonorrhoea, clinicians try to find the context of where the SAI came from and where it could possibly spread. The clients’ sexual history are utilised to trace the SAI, but problems are encountered because of the anonymous nature of some of these sexual encounters that originate from an online sources. People sometimes do not even know the person's name or do not have any contact numbers, thus sexual contacts are difficult to track down. People in their 20s still have the highest gonorrhoea rates in 2015, with 20 to 24 year olds followed by the 25 to 29 year olds and the 44 to 49 years. That was followed by 60% at 69% for 50 to 54 year olds at 67.6% at 17.6 cases.

#NORWAY

In Norway, the number of notified gonorrhoea cases is now the highest for 25 years. In 2015, 851 gonorrhoea cases were reported, compared to 682 cases in 2014. The significant increase of gonorrhoea among men who have sex with men (MSM) began in 2010 and continued in 2015. Gonorrhoea among heterosexual men and women also continued to increase. Of the men, 444 were infected homosexually, 243 were infected heterosexually, and the sexual orientations of 3 men were unknown. All the women were infected heterosexually.

#TAIWAN

In Taiwan, the local Centres for Disease Control said that gonorrhoea cases increased by 37 percent where the highest rate is amongst teenagers. A total of 3584 confirmed gonorrhoea cases were reported last year in 2015, an increase of 37 percent from the previous year 2014 (Yen-fang (2016).The number of reported cases among adolescents aged 10 to 19 increased by 47 percent last year with the youngest cases involving 13-year-olds (2 males and 2 females). Men accounted for 93.5 percent of all reported gonorrhoea cases, with male cases increasing by 36 percent last year 2015, cases involving women rose by 41 percent.

#UK

Another recent report from the UK was an outbreak of drug-resistant gonorrhoea. The outbreak first emerged with 16 cases among residents of Leeds and the north of England and the outbreak has since spread to the West Midlands and south of England, including London. Initial cases were among heterosexuals but more recent evidence suggested spreading among men who have sex with men. Partner notification has been of limited success.

#MALTA

In Malta we have had 66 cases of gonorrhoea in 2015, of which 33 were males who have had sex with males. The age groups which were mostly affected were in the 31-35 years and 36-40 years old categories, followed closely by 21-25 years old and 16-20 years old category. Just few months into the year 2016 and we have had, 24 cases of gonorrhoea already reported. We face similar problems locally to the rest of the world, one of which is contact tracing. Anonymous sexual practices make testing and treatment of all sexual contacts very difficult. In addition, condom use is also lacking.

In addition to this information alert, I would also like to outline some information on gonorrhoea.

Gonorrhoea is a common bacterial infection that affects the reproductive system. Symptoms in men include a burning or painful sensation during urination, which might develop between 2 and 7 days after infection. Women often do not develop any overt symptoms, so infections can go undetected.

Such an infection causes scarring of the fallopian tubes and without prompt treatment; gonorrhoea can lead to infertility in women and also in men. Men most often seek medical attention first and later on informing their partners after their diagnosis with gonorrhoea. People can get gonorrhoea through vaginal and anal sex. It's also possible to get the disease through oral sex. A pregnant woman can also give gonorrhoea to her baby during delivery and is usually detected through eye infections present in the newborn.

There are several things that one could do to lower the risk of gonorrhoea:

Using condoms for each sex act (oral, anal, and vaginal). A condom should be put on before any sexual contact takes place.

Having sex with only one partner (who only has sex with you)

Appropriate testing and treatment. Talk with your doctor to see what SAI testing might be recommended for you.

Talk to your partner/s

One has to be careful with whom one makes friends with, on the Internet; refrain from having unsafe sex with people whose sexual history one is unfamiliar with; avoid sex parties and multiple sexual partners; use condoms and water-based lubricants at all times when having sex and avoid the use of narcotics.

Therefore I end my article today by reminding you of the GU clinic number for free and confidential checkups; 21227981. I will be back with more news and information next month.

Maltese Gender Identity Law [Transgender / Intersex]

Civil Unions Parliamentary Debate and Vote

Note: The Civil Unions Bill [20/2014] has successfully passed through the Maltese Parliament with 37 votes in favour, 30 absentions and 0 votes against on the 14th April 2014. It gives the same rights and obbligations to same-sex couples as those who are registered in a civil marriage (mutatis mutandis).